TACE联合分子靶向药索拉菲尼治疗晚期肝癌远期疗效观察  

Transcatheter arterial chemoembolization combined with molecule-targeted sorafenib for the treatment of advanced hepatocelluar carcinoma: observation of its long-term efficacy

作　　者：陈世晞[1] 陈骏[1] 席玮[1] 徐卫东[1] 尹国文[1] 徐清宇[1] 

机构地区：[1]210009南京江苏省肿瘤医院介入科

出　　处：《介入放射学杂志》2011年第12期958-960,共3页Journal of Interventional Radiology

摘　　要：目的评价经肝动脉灌注化疗栓塞术(TACE)联合分子靶向药物甲磺酸索拉菲尼治疗晚期肝细胞肝癌(HCC)的临床疗效和不良反应。方法 2007年6月至2009年5月,江苏省肿瘤医院介入科收治的30例晚期HCC患者,采用经TACE或单纯动脉灌注化疗,术中用药为氟脲苷1.0 g,羟基喜树碱20 mg,吡柔比星30 mg,碘油栓塞肿瘤供血动脉。口服甲磺酸索拉菲尼,起始剂量400 mg,每日2次,治疗过程中根据不良反应情况调整用量。每6～8周复查1次,评价肝功能,治疗效果(CT复查、术中DSA等)和不良反应。用SPSS13.0软件统计计算中位生存时间,平均生存时间和无疾病进展时间。结果至2009年12月,30例患者均达到临床评价要求,无中途停药。口服索拉菲尼相关不良反应发生率83.3%。主要不良反应为手足皮肤反应、腹泻和高血压。无疾病进展期内DSA术中造影可见肿瘤血管较服药前稀疏,纤细。经统计学分析,中位生存期38周,平均生存期41周,无疾病进展时间18周。结论晚期肝癌,经TACE术联合索拉菲尼口服治疗无严重不良反应发生。Objective To assess the clinical effect and safety of transcatheter arterial chemoem-bolization combined with molecule-targeted sorafenib for the treatment of advanced hepatocelluar carcinoma.Methods During the period from Jun.2007 to May 2009,transcatheter arterial chemoembolization combined with molecule-targeted sorafenib was carried out in thirty patients with advanced hepatocelluar carcinoma.Transcatheter arterial chemoembolization were performed in all cases.The drugs used in the procedure included F-udR（1.0 g）,OPT（20 mg） and THP（30 mg）.Lipiodol was used to obstruct the tumor-feeding arteries.Sorafenib was orally administered twice daily with the dose of 400 mg,and the dose was dynamically adjusted according to the occurrence of adverse effects.Liver function,CT and DSA were reexamined every 6-8 weeks to evaluate each patient＇s condition.The results were analyzed.The median survival time and the mean survival time were calculated by using SPSS13.0 software.Results The incidence of sorafenib-related adverse effects was 83.3%.The main adverse effects were hand-foot skin reaction,diarrhea and hypertension.Angiography performed in non-progressive period showed that the tumor vessels became few,scattered and very thin.Statistical analysis indicated that the median survival time was 38 weeks and the mean survival time was 41 weeks,while the non-progressive period was 18 weeks.Conclusion Transcatheter arterial chemoembolization combined with orally administered sorafenib can markedly prolong the survival time of the patients with advanced hepatocelluar carcinoma.Besides,this therapy carries no severe adverse effects.

关 键 词：肝动脉灌注化疗栓塞术 索拉菲尼 晚期肝癌 

分 类 号：R735.7[医药卫生—肿瘤]